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South Dakota rates for HCPCS V2530

Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.57 / $247.63 / $298.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$413.63 / $413.63 / $517.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$284.50 / $291.33 / $480.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.07 / $133.55 / $1,689.04
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$285.00 / $294.45 / $522.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.16 / $248.35 / $266.61
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.02 / $291.33 / $366.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.57 / $133.55 / $356.93
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.92 / $240.92 / $240.92